National Provider Identifier Database

PERRY COUNTY COUNSELING CENTER INC
Professional


Contact Information

PERRY COUNTY COUNSELING CENTER INC
8271 E JACKSON STREET RD
DU QUOIN, IL62832-3811
Phone: 618-542-6722
Fax: 618-542-6623
Website:
Specialty Taxonomy Code
* Professional 101YP2500X
Addiction (Substance Use Disorder) 101YA0400X
Clinical 1041C0700X
Prescribing (Medical) 103TP0016X

* Indicates primary specialty

NPI Profile & details for PERRY COUNTY COUNSELING CENTER INC

NPI Number 1851533996
Legal business name
LBN
PERRY COUNTY COUNSELING CENTER INC
Authorized official JOHN VENSKUS - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 04/06/2009
Last updated 04/06/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • License #: 036077893
  • IL License #: 149008165
  • IL License #: 149010561
  • IL License #: 149012186
  • IL License #: 180003682
  • IL License #: 180004129
  • IL License #: 180004366
  • IL Medicaid: 012300790

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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